Pan Ting, Lee Jae Woo
Shanghai Key Laboratory of Lung Inflammation and Injury, Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Department of Anesthesiology, University of California Los Angeles, Los Angeles, CA 90230, USA.
Chin Med J Pulm Crit Care Med. 2024 Feb 3;2(1):34-41. doi: 10.1016/j.pccm.2023.10.004. eCollection 2024 Mar.
Neutrophil extracellular traps (NETs), extrusions of intracellular DNA with attached granular material that exert an antibacterial effect through entangling, isolating, and immobilizing microorganisms, have been extensively studied in recent decades. The primary role of NETs is to entrap and facilitate the killing of bacteria, fungi, viruses, and parasites, preventing bacterial and fungal dissemination. NET formation has been described in many pulmonary diseases, including both infectious and non-infectious. NETs are considered a double-edged sword. As innate immune cells, neutrophils release NETs to kill pathogens and remove cellular debris. However, the deleterious effects of excessive NET release in lung disease are particularly important because NETs and by-products of NETosis can directly induce epithelial and endothelial cell death while simultaneously inducing inflammatory cytokine secretion and immune-mediated thrombosis. Thus, NET formation must be tightly regulated to preserve the anti-microbial capability of NETs while minimizing damage to the host. In this review, we summarized the recent updates on the mechanism of NETs formation and pathophysiology associated with excessive NETs, aiming to provide insights for research and treatment of pulmonary infectious diseases.
中性粒细胞胞外陷阱（NETs）是细胞内DNA与附着的颗粒物质的挤出物，通过缠绕、隔离和固定微生物发挥抗菌作用，近几十年来受到了广泛研究。NETs的主要作用是捕获并促进对细菌、真菌、病毒和寄生虫的杀伤，防止细菌和真菌扩散。NETs的形成已在许多肺部疾病中被描述，包括感染性和非感染性疾病。NETs被认为是一把双刃剑。作为固有免疫细胞，中性粒细胞释放NETs以杀死病原体并清除细胞碎片。然而，在肺部疾病中过量释放NETs的有害影响尤为重要，因为NETs和NETosis的副产物可直接诱导上皮细胞和内皮细胞死亡，同时诱导炎性细胞因子分泌和免疫介导的血栓形成。因此，必须严格调节NETs的形成，以保持NETs的抗菌能力，同时将对宿主的损害降至最低。在这篇综述中，我们总结了NETs形成机制和与过量NETs相关的病理生理学的最新进展，旨在为肺部感染性疾病的研究和治疗提供见解。
